THE ROLE OF DYNAMIC CONTRAST HARMONIC IMAGING ENDOSCOPIC ULTRASOUND (CHI-EUS) AND CD105 AND CD31 IMMUNOSTAINING IN TUMOR ANGIOGENESIS ASSESSMENT ON PATIENTS WITH GASTRIC CANCER – A FEASIBILITY STUDY.

Angiogenesis is a critical process for tumor growth and metastasis, it is now considered an important marker of disease prognosis and sensitivity to anticancer therapy. However, gastric cancer (GC) studies are rather scarce. CHI-EUS was proposed in this study as a useful method to assess GC vascularization patterns. Patients initially diagnosed with GC, only adenocarcinoma type, who subsequently performed CHI-EUS examinations before any treatment decision, were included in this study. Dedicated software named Vuebox (Bracco Imaging S.p.A., Milan, Italy) was used to quantitatively evaluate angiogenesis in the chosen regions of interest (ROI). As a result, this software generated automatically parameters derived from time-intensity curve (TIC) like peak enhancement (PE), rise time (RT), time to peak (TTP), wash in perfusion index (WiPI), ROI area, and others were compared to immunohistopathological data. CD105 and CD31 immunostaining was performed to calculate the vascular diameter (vd) and the microvascular density (MVD). The final results were compared with CHI-EUS parameters. A total of eighty CHI-EUS video sequences were assessed. Multiple high statistical correlations (p<0.05) were highlighted between TIC analysis parameters, MVD, and vd CD31. Also, strong correlations were found between tumor grade and CHI-EUS parameters, p<0.005. Differences in TIC parameters and immunohistochemical markers between the group of patients without (M0) versus the group with (M1) metastasis were noted. Our study demonstrated that GC angiogenesis assessed by CHI-EUS was a feasible method and may be considered for future studies based on TIC analysis. [ABSTRACT FROM AUTHOR]